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Case Reports
. 2021 May 27;15(1):273.
doi: 10.1186/s13256-021-02802-9.

Felty syndrome: a case report

Anupam Gupta  1 , Aryan Abrahimi  2 , Aesha Patel  3
Affiliations
Case Reports

Felty syndrome: a case report

Anupam Gupta et al. J Med Case Rep. .

Abstract

Background: Felty syndrome is a rare manifestation of chronic rheumatoid arthritis in which patients develop extraarticular features of hepatosplenomegaly and neutropenia. The typical presentation of Felty syndrome is in Caucasians, females, and patients with long-standing rheumatoid arthritis of 10 or more years. This case report presents a patient with an early-onset and atypical demographic for Felty syndrome.

Case presentation: Our patient is a 28-year-old African American woman with past medical history of rheumatoid arthritis diagnosed in 2017, asthma, pneumonia, anemia, and mild intellectual disability who was admitted to inpatient care with fever, chills, and right ear pain for 7 days. The patient's mother, also her caregiver, brought the patient to the hospital after symptoms of fever and ear pain failed to improve. Our patient was diagnosed with sepsis secondary to pneumonia and urinary tract infection. She had been admitted twice in the past year, both times with a diagnosis of pneumonia. During this visit in September 2019, it was discovered that the patient had leukopenia and neutropenia. Bone marrow biopsy revealed increased immature mononuclear cells with left shift and rare mature neutrophils. During the hospital course, the patient was provisionally diagnosed with Felty syndrome and treated with adalimumab and hydroxychloroquine for her rheumatoid arthritis. Her sepsis secondary to pneumonia and urinary tract infection was treated with ceftriaxone and doxycycline, which was later switched to cefepime because of positive blood and urine cultures for Pseudomonas aeruginosa. She was discharged with stable vital signs and is continuing to control her rheumatoid arthritis with adalimumab.

Conclusion: This case report details the clinical course of sepsis secondary to pneumonia and urinary tract infection in the setting of Felty syndrome. Our patient does not fit the conventional profile for presentation given her race, age, and the length of time following diagnosis of rheumatoid arthritis.

Keywords: Anemia; Felty syndrome; Neutropenia; Pneumonia; Rheumatoid arthritis; Splenomegaly.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Owlia MB, Newman K, Akhtari M. Felty’s syndrome, insights and updates. TORJ. 2014;8(1):129–136. doi: 10.2174/1874312901408010129. - DOI - PMC - PubMed
    1. Xiao R-Z, Xiong M-J, Long Z-J, Fan R-F, Lin D-J. Diagnosis of Felty’s syndrome, distinguished from hematological neoplasm: a case report. Oncol Lett. 2014;7(3):713–716. doi: 10.3892/ol.2013.1779. - DOI - PMC - PubMed
    1. Sienknecht CW, Urowitz MB, Pruzanski W, Stein HB. Felty’s syndrome. Clinical and serological analysis of 34 cases. Ann Rheum Dis. 1977;36(6):500–507. doi: 10.1136/ard.36.6.500. - DOI - PMC - PubMed
    1. Patel R, Akhondi H. Felty syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020. Updated 10 Jan 2020.
    1. Turesson C, Schaid DJ, Weyand CM, et al. The impact of HLA-DRB1 genes on extra-articular disease manifestations in rheumatoid arthritis. Arthritis Res Ther. 2005;7(6):R1386. doi: 10.1186/ar1837. - DOI - PMC - PubMed

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